Individual provider Active NPI

Laurence Loleneko Cabalar Palma, IDC

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1720742877
Registry record updated Oct 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000
Phone
(619) 532-7968
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X 1720742877 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

34101 Farenholt Ave BLDG 14
San Diego, CA 92134-7000

Mailing address

1031 Calle Deceo
Chula Vista, CA 91913-3345
Phone (702) 493-9716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1720742877CAMDIndependent Duty Corpsman

Practice roles

OrganizationSpecialtyStatusNew patients
United States Navy PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760227200000",
    "number": "1720742877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 CALLE DECEO",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919133345",
            "telephone_number": "702-493-9716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34101 FARENHOLT AVE BLDG 14",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921347000",
            "telephone_number": "619-532-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMA",
        "first_name": "LAURENCE",
        "middle_name": "LOLENEKO CABALAR",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2025-10-12",
        "certification_date": "2025-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": "1720742877",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.